Taking Community Action Against Pain

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DESCRIPTION (provided by applicant): The proposed project, entitled Taking Community Action Against Pain, addresses the problem of chronic pain (CP) in older persons, which is a highly prevalent, morbid, and costly disorder that is associated with a substantial burden of suffering in this age group. Evidence-based treatments for CP in the form of self- management programs have been developed for use in the community and have demonstrated efficacy, but have not been widely disseminated. Numerous barriers likely exist at the individual, program, and cultural level that have a negative impact on program translation efforts and are in need of characterization. The development of strategies to overcome the barriers is necessary to improve both program reach and program benefits. Using community based participatory research (CBPR), this application seeks to answer the following scientific questions: 1) What are the major barriers to adoption of and adherence to a pain-reduction protocol by seniors with CP?; 2) How can an evidence-based pain protocol be adapted using CBPR to better meet the needs of seniors from three distinct race/ethnicity groups including African American, Hispanic American, and non-Hispanic White Americans?; and 3) What is the effect of using a CBPR-based program versus a conventional CP program on the effectiveness of the pain protocol? The following aims are proposed to address the above questions: 1) Expand and maintain existing community-researcher partnerships, 2) Access local knowledge and resources to design optimal methods for program implementation and possible adaptation; 3) Synthesize findings from these activities to generate pain programs for our senior center partners; 4) Pilot test the new programs; and 5) Compare CBPR program outcomes to those generated via the conventional pain program, i.e., `usual care', and 6) Disseminate project findings and related products. Anticipated products of this project include: 1) Pilot data for use in a subsequent R01 application; 2) New programs are anticipated to emerge as a result of accessing the collective resources and knowledge of our community partners; 3) Knowledge regarding the effects of using CBPR versus `usual care' on the effectiveness of a pain intervention program; and 4) Publication of scholarly articles and reports tailored to a wide range of practitioners. The project will take place in culturally diverse senior centers located throughout New York City, which is appropriate given that 10 million older adults (up to 50% of whom have CP) currently use services provided by over 15,000 senior centers in the U.S. The planned work has significant potential to reduce the substantial morbidity and suffering associated with CP among seniors. This project seeks to improve the health and well being of older adults with chronic pain due to arthritis and/or arthritis-related diseases. The project will develop and test culturally sensitive pain-management programs for use in the community by adults aged 65 and above who belong to one of 3 race/ethnicity groups: African Americans, Hispanic Americans, and non-Hispanic White Americans. To ensure cultural relevance of the programs, the investigators have proposed to partner with diverse community groups to include older adults with chronic pain as well as staff from centers that will ultimately host the programs (e.g., senior centers).